[Does experimental surgery still exist?]

[Surgical research in Germany. Organization, quality and international competitiveness]

Surgical research in Germany is performed within surgical clinics by individual working groups or in surgical research divisions. Additionally, a few independent institutes and departments of surgical research have been established at medical faculties. The number of these institutions, however, is too small. To increase productivity in surgical research, structural changes are necessary, including additional establishment of further institutes and professorships. The quality of clinical research in surgery in Germany is critically discussed. International comparison shows that Germany has a low ranking with respect to the number of clinical studies published in leading surgical journals. However, there has been some improvement in the quality of clinical studies performed in surgical departments during the last 15 years. The establishment of the study center of the German Society of Surgery shows that excellent clinical studies with adequate numbers of patients can also be performed in Germany and can be published in leading journals. Accordingly, there is need to distribute the structures and the competence necessary to perform clinical studies in a standardized manner to all surgical departments involved in clinical research. The experimental surgical research in Germany is not adequately visible, although over the last 10 years the most relevant publications from institutions for surgical research have been placed in journals with a mean impact factor of 8. This may be due to the fact that 85% of these top publications are published in non-surgical journals. The aim for the future must therefore be to increase the impact factor and, thus, the attractiveness of surgical journals. This may be achieved by publishing the highest quality results from experimental surgical research not in non-surgical but in surgical journals.

How to ensure the survival of the surgeon-scientist? The Homburg Program

BACKGROUND

Academic surgery requires competence in research, teaching, and patient care. Because of the increasing complexity of both surgical research and clinical surgery, and additional skills necessary for adequate patient care, including economics, management, and organization, it becomes more and more difficult to provide an attractive education for surgeon-scientists. This has resulted in a dramatic decline in the number of surgeon-scientists in the past and alarms us to systematically restructure our research training system.

DISCUSSION

We herein introduce a program involving the clinical departments of surgery, trauma surgery, and cardiac-thoracic surgery as well as a surgical research institution. The program allows the clinical departments to sharpen their overall research profile and facilitates the establishment of competent working groups, guaranteeing long-term research activities on a high scientific level. The program involves both surgical residents and medical students, who will represent our future generation of academic surgeons, ensuring the survival of the surgeon-scientist.